긴장성 요실금에서 Raz술식의 치험 106례

Abstract

From January, 1990 to December, 1995, 106 patients received transvaginal bladder neck suspension by Raz. Followup periods ranged from 3 monhths to 5 years, and mean age of patientss was 52.2 years.s Severity of incontinence were grade I in 22, grade II in 83, and grade III in I patient. Afte rminimum of 3 months followup, 87 (82.1%) patients were completely cured and 14 (13.2%) patients reported minimal leaking, the final success rate being 95.3% (101/106). Degree of posterior urethral angle kand grades of incontinence (classified either by Blaivas or Green) were n9ot significant factors in predicting outcome. Grade of incontinence, preoperative irritative voiding ksymptoms, previous incontinence surgery, age, and menopause were not correlated with success. However the history of hystrectomy and overweight were related with lower success rate. Mean hospital stay was 6.1 days, and 50 (47.2%) patients performed intermittent atheterization at discharge but later all resumed normal voiding. Among 34 paktients with urgency preoperatively 25 (73.5) improved after operation, and de novo urgency was found in 11 (16.2%). Complications including urinary tract infection, blood perforation, and wound perforation was seen. Success rate of Raz operation is more than 90%, which was higher than other types of bladder suspension. Raz colposuspension can place bladder neck traction sutures accurately without causing obstruction or significant morbidity, therefore should be recommended as a premier mode of surgical treamtment in patients with stress urinary incontinence.